The dogs are part of the health system’s new three-tiered security force, conceived partly as a result of the Pulse shooting tragedy and other mass shooting incidents across the country.

“We’re a large hospital system, and there are multiple goals we’re trying to meet,” said Eric Stevens, senior executive officer of acute care service at Florida Hospital, overseeing the eight Central Florida campuses. “We want to create an environment that’s easy to use, friendly and open in a world that’s changing, while keeping our patients safe.”

Florida Hospital’s efforts are part of the changing face of security in health care, which has mostly been in the background. Violence against hospital staff is not a new issue, but the type of violence and threats within the hospital walls are a direct reflection of what happens in the community, experts say.

“If you talk to security professionals, most say that these needs have been there for years,” said Alan Butler, president-elect of International Association for Healthcare Security and Safety. “But what’s happening in the society has exacerbated it and brought it to the forefront.”

Although there are guidelines and recommendations for hospital security, they’re somewhat broad. And health systems take different approaches. Also, unlike some quality initiatives, security measures are not reimbursed, and they’re expensive to implement.

“Security is a cost center, said Butler. “Some organizations invest more than others, but its a balancing act.”

Most available information seems to show that a health system’s security measures are mostly driven by what’s happening in the community. “They seem to be less proactive, and more reactive,” said Loretta Forlaw, assistant professor of nursing at University of Central Florida who is studying security trends in health care settings.

Local hospitals are no exception.

Soon after the Pulse tragedy, Orlando Health, which received the bulk of the victims after the shooting, limited the number of entryways to its downtown hospitals and placed permanent security personnel and metal detectors at each entrance.

Nemours placed a uniformed Orlando Police officer on its campus, with a police cruiser parked in a visible location.

“The world around us is changing,” said Randy Hartley, chief operating officer at Nemours, in a 2017 interview. “Violence seems to be less and less of an exception.”

Florida Hospital has invested $3.5 million in bolstering its security measures since Pulse, said Stevens. Some of the measures are more visible to the public than others.

The health system now has 2,500 cameras installed across its Central Florida facilities. It’s equipped the security guards with metal detectors, and by late April, it’s launching a mass notification system for all employees, an initiative that’s also been undertaken by Orlando Health.

Another 150 uniformed officers will be equipped with batons, pepper sprays and body cameras by late February. And around the same time, half-a-dozen canines, trained to detect gunpowder, will start patrolling the facilities.

The health system is planning to have at least a dozen canines across its Central Florida campuses by the end of this year.